Provider Demographics
NPI:1548217938
Name:SCLAMA, ANTHONY S (MD, MSB)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:S
Last Name:SCLAMA
Suffix:
Gender:M
Credentials:MD, MSB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6830 HOSPITAL DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4373
Mailing Address - Country:US
Mailing Address - Phone:410-391-6131
Mailing Address - Fax:410-391-6144
Practice Address - Street 1:6830 HOSPITAL DR
Practice Address - Street 2:SUITE 204
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4373
Practice Address - Country:US
Practice Address - Phone:410-391-6131
Practice Address - Fax:410-391-6144
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0024474208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD731LO985Medicare PIN
MDB70639Medicare UPIN